NURS2006 Clinical Practice Improvement Project Report Assignment


Added on  2020-04-01

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CLINICAL PRACTICE IMPROVEMENT PROJECT 1NURS2006 ASSIGNMENT 3Clinical Practice Improvement Project ReportStudent Name, FAN and ID:Project Title:Clinical Handover Communication using Patient Intervention Comparison (PICO)Project Aim:To explore whether using ISOBAR technique for clinical handovers as compared to general verbal technique can help in reducing the percentage of clinical errors in health care settings. Relevance of Clinical Governance to your projectClinical governance refers to the framework and criteria employed by the NHS organizations to improve the quality of services offered as well as safeguarding the high standards in medical care through the creation of excellence environment for clinical healthcare. Clinical government is not only limited to the NHS organizations but also entails a practice management and integrated principles which are used in successful dentistry. Clinicalhandovers mechanisms were introduced in order to reduce the probability of the clinical errors in the medical settings, however in most cases, the concept of clinical handovers are not complied with in an optimal manner (Black et al., 2015). There are many prevalent challenges or issues in the clinical setting involving inadequate usage of clinical handovers, a few key challenges in this situation are: One of the key issues that have identified in this scenario had been the alarming rate of negative consequencesin the care planning and execution for the patients for the lack of proper communication during shift handovers. According to the Boswell et al., 2015, one of the most important factors associated with nursing handovers is the fact that it contains key information regarding the condition of the patient and what principle
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CLINICAL PRACTICE IMPROVEMENT PROJECT 2measures are to be taken while handling that particular patient. In cases where the nursing handover guidelines are not followed properly, the care standards and quality suffers. Elaborating more, the nursing handovers are of crucial importance in the scenarios where the patients need to be relocated to different wards in critical conditions, in situations where the nursing handovers do not contain enough information; the medical complications of the patients have been seen to deteriorate to even life threatening conditions. Hence,not adhering to handover protocols is a direct indication of compromised clinical performance standards (Johnson et al. 2014). Considering the clinical standards, there are different practices for clinical handover followed, while in some cases bedside handovers are a protocol, in some scenarios the method of informal verbal handovers is followed extensively. However, the verbal handover technique is not just informal but is constitutes chances of major clinical errors. According to the detailed study by authors, it has been discovered that the verbal mode ofnursing handovers are extremely inadequate to relay detailed information about the condition of the patient tothe attending nurses. Along with that another major concept is the fact that conveying information about the patient cannot complete the authenticity and reliability of a bedside documented nursing handover (Boswell et al., 2015).Environmental Safety for Staff, Patient and Public is also another essential governance policy which one needs to evaluate in clinical practice and implementation. In fact, the policy outlines that patients have an equal right to clean as well as safe treatment all the time. The system is essential in building the confidence of patients as they receive health care by outlining the set procedures at designated stages in nursing. Thus, Health and Safety at Work Act 1974 form the fundamental grounds for keeping patients safe in the hospital while at the same time helps in protecting workers. Therefore, the policy aims at setting out the responsibilities which the employer has towards both the employees and public as a whole. Additionally, the act also encourages companies in examining workplace risks as well as in coming up with measures of addressing the challenges in
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CLINICAL PRACTICE IMPROVEMENT PROJECT 3return (Mikkonen et al., 2016 p.187).Fair and manageable care is another key theme which governs clinical care practices. This aims at provide prompt healthcare services as well as gives patients access to treatment. Fair and manageable care is governedby Human Rights Act of 1998, Race Relations and its Amendment Act (2000) and Infirmity Discernment Act 1995. In essence, the Race Relations Act enhances equity and good mutual relations among people of distinct groups. This includes having access to services to help patients of various ethnicities to make utilization of and completely comprehend the neighbourhood dental administrations accessible. The Human Rights Act covers a scope of political and social equality and the Disability separation act makes it unlawful to oppress a man on the grounds of handicap in the range of business, offices, and administration. An entrance review ought to be done by an outsider to survey current consistency under this demonstration and to acquaint enhancements in access with debilitated patients.Considering the scope for professional development and management, the issues prevalent in this sector due to improper usage of clinical handovers are many. First and foremost it has to be mentioned nursing is a profession that is absolutely evidence based. And there are many instances where the nursing professionals have to take reasonable clinical decisions where the patients are in need of immediate nursing interventions in critical conditions. These activities do not only broaden the scope of practice for the nursing individual, but alsocontributes to their professional growth and enhances their ability to handle critical patients. However, these emergency decisions are very crucial, and a single error can cost the patient severely and even lead to penalizing consequences for the nursing professional as well (Clarke and Persaud 2011). According to the Elwynet al. 2013, the information in the nursing handover is crucial for the shift change nurse to understand the basiccare needs of the patients and a general idea of the condition that the patient is in, in case t6hat information is relayed is an inadequate manner, the concept of correct patient assessment and care planning is disrupted. It can also be stated in this context that the incomplete information provided to the nursing professional in the
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CLINICAL PRACTICE IMPROVEMENT PROJECT 4handover can potentially misguide him or her leading to severe consequences. Which further narrows down the scope for professional development of the nursing professional and rather imparts negative effect on the career growth of the person (Elwyn et al. 2013). Now considering the clinical risks associated with the chosen scenario, there are a multitude of different risks that are prevalent in scenarios where the clinical handovers are either not optimal or are not followed as a regular regime. It has to be understood that the data about the patients regarding vital signs, patient problem, health status, allergic reactions, past medical history, medication charts and risk factors are stated with clarity. In case of verbal handovers, it is impossible for the nursing professional to incorporate each and every intricate detail while communicating with the shift change nurse. Hence, clinical errors like flawed medication administration, hospital acquired infection, fall, allergic manifestations and even cardiac issues can arise. Hence, there had been a need for a standardized technique of maintaining nursing handovers with a protocol to strictly comply (Flemming and Hübner 2013). Considering the government initiatives, there have been many steps taken to ensure optimal consumer value while providing safe health care services, however, with the lack of an imperative guidelines or protocol to maintain in handover system that incorporates the importance of traceability of clinical decisions made by the nursing professional communicating the subjective issues of the patient clearly decreases the possibility of the full story of the patient to be shared with the shift change nurse (Boswell et al., 2015). Evidence that the issue/problem is worth solving:From the literature search and evaluation, it can be stated that nursing handovers are a necessity, and the nursing handovers should be integrative and detailed, utilized every time the patient is assessed by the nursing professional. That is the reason a few government initiatives have been taken while considering the nursing handover implementation. For instance, the first government initiative regrading standardizing nursing handovers had been the “safe handover: safe patient’ scheme introduced by the British government in the year
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